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How can I lactate properly? Using nipple shield for inverted nipples. Use breast pump more often?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
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Hi,

My daughter is now 2 months old and my wife is breast feeding her. Since last 5 days, her breasts are not producing enough milk. My wife is trying below things:
- drinking plenty of water
- frequent nursing
- offering both breasts at each feeding

She has busty breasts ans has inverted nipples so she uses nipple shield. We did try feeding her directly but she was not able to latch properly and the baby started loosing weight. SO we start using nipple shield. Can you recommend us how she can produce more milk? How long will it take for her to start producing enough milk. Initially she use to produce enough milk but it decreased a lot now. Should she use a breast pump tp pump more often?

Please help!
Posted Mon, 1 Oct 2012 in Parenting
 
 
Answered by Dr. Hema Yadav 26 minutes later
Hello,
Thanks for posting your query.
Please do not worry.
Inverted nipples is a common complain especially in first time mothers and soon will resolve as the baby continues to breastfeed . You can try nipple sheild but intermittently once in a day do give her direct feed without it .
The most common reason for inadequate milk is stress in mother and inadequate suckling by child . I do appreciate your wife for taking appropriate precautions as you mentioned but in addition to that the most important thing she can do is to avoid stress at all costs . Please do not make her feel that there is a problem with her breasts which caused the baby to lose weight . It's not so , it's a common phase and within a month or two all such issues are sure to resolve on their own.
The more she worries about her milk output the less it will be . So let her take ample of rest , sleep and positive thoughts along with bonding with baby to have a healthy milk output.
Still if you feel she does not have a good output and the baby cries for more then you can always start her on lactagogues like Satvarex powder ( usually 2 tablespoons twice daily with milk ) or medicines like metoclopromide as per her doctors prescription .This will ensure an increased output.
If the problem is more of engorged breasts and inverted nipples causing improper latching and interference with nipple shield the you should consult a lactation consultant or specialist trained to deal with such issues ( most hospitals have such trained pediatricians who work as lactation consultants ) . They can teach her syringing a method used to pull out nipples using empty cut disposable syringes applying forceful suction outward .They can also teach her simple breast exercises for the same which will also help her with milk output.
Breast pumps would help if she has engorgement of breasts causing difficult latching otherwise frequent nursing is better than pumping.

So there are many solutions and please do not lose hope . The fact that she wants to continue exclusive breastfeeding is commendable and the best gift she can give her baby.Please have a positive outlook and I assure that everything will be fine soon.
Hope I have answered your query.
Kindly accept my answer in case you have no further queries .
Regards
Above answer was peer-reviewed by
 
Follow-up: How can I lactate properly? Using nipple shield for inverted nipples. Use breast pump more often? 25 minutes later
Thanks for your detailed reply. I do tell her not to worry. The problem is there are no experts at hospitals in her area. I didn't understand what you meant by this:

"Still if you feel she does not have a good output and the baby cries for more then you can always start her on lactagogues like Satvarex powder ( usually 2 tablespoons twice daily with milk ) or medicines like metoclopromide as per her doctors prescription .This will ensure an increased output XXXXXXX

Is this for mother or the baby?

 
 
Answered by Dr. Hema Yadav 59 minutes later
Hello,
Thanks for the follow up.
Sorry , let me be clear , it's for the mother only .Please note that nothing needs to be given to the baby.
Lactagogues / galactagogues are natural products which are given to lactating mothers to increase milk supply . So either natural products ( satvarex ) and medicine ( metoclopromide ) are given to the mother by their doctors ( gynaecologist ) in case of decreased output.
So I meant that even if with simple measures like avoiding stress, adequate sleep , proper latching , frequent feeding the milk output is very low and baby is very hungry and cries for milk then you should consult a gynaecologist who can start the mother on galactogogues ie satvarex etc

Also I would suggest her to completely empty one breast in one feeding ( which usually takes about 10-15 min atleast)before changing over baby's mouth to the other breast . This will ensure that the baby has more of the fatty hind milk which will satisfy her hunger and increase weight gain . If after completing one breast baby is latched on to the other side but does not take much then some amount can be pumped out to prevent engorgement .
If baby drinks from the other side after finishing one side then no need of pumping .for next feeding latch the baby to the second leftover breast first .

This way baby will have both foremilk ( which is watery and satisfies thirst ) and hind milk ( which is fatty and satisfies hunger).
Hope I have answered your query.
Kindly accept my answer in case you have no further queries.
Regards.
Above answer was peer-reviewed by
 
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